Background: Dysmenorrhea is one of the most common primary care complaints among reproductive-aged women, and it significantly detracts from patient quality of life. First-line treatments include non-steroidal anti-inflammatories and combined oral contraceptives, however, there is growing interest in acupuncture and related modalities as treatment options, though current evidence of efficacy and effectiveness is limited.
Methods: To assess the status of the current evidence basis, a systematic review of pain relief obtained through use of acupuncture was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) principles, including literature from 2016 through 2021. After manual review, 12 articles were retained for analysis.
Results: Despite consistent reporting of pain relief due to acupuncture modalities by patients with dysmenorrhea, the reviewed studies included varying levels of quality, risks of biases, and inconsistent methodologies. As the primary outcome measure, all studies reported various levels of mitigation of pain with acupuncture; in additional studies use of analgesics was reduced, and patient quality of life improved, though overall with small sample sizes, low-powered studies, subjectivity, and significant potential for confounding.
Conclusions: The overall evidence for acupuncture-related modalities to alleviate dysmenorrhea requires additional investigation. Use of objectivity in outcome measures, quality standards in RCT reporting and standardized study are crucial to determining the significant benefit of this therapy. Reassuringly, there seems to be little harm to the use of acupuncture, which represents a skill increasingly practiced by physician extenders, and a treatment option increasingly sought out by patients wishing to avoid use of traditional therapies.
Kucia MM. Integrating the Integrative: Acupuncture in the Management of Primary Dysmenorrhea. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2021; 3(3).
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